Concreteness of idiographic worry and anticipatory processing

doi:10.1016/j.jbtep.2016.08.005

Journal of Behavior Therapy and Experimental Psychiatry

Volume 54, March 2017, Pages 195-203

https://doi.org/10.1016/j.jbtep.2016.08.005 Get rights and content

Highlights

•
Examined verbal-linguistic vs. imaginal activity, as well as concreteness, during RNT.
•
Worry and anticipatory processing were more verbal and abstract than uninstructed.
•
Worry was more abstract and verbal-linguistic than anticipatory processing.
•
Anticipatory processing was more imagery-based than worry.
•
Both worry and anticipatory processing became more abstract over time.

Abstract

Background and objectives

Worry and anticipatory processing are forms of repetitive negative thinking (RNT) that are associated with maladaptive characteristics and negative consequences. One key maladaptive characteristic of worry is its abstract nature (Goldwin & Behar, 2012; Stöber & Borkovec, 2002). Several investigations have relied on inductions of worry that are social-evaluative in nature, which precludes distinctions between worry and RNT about social-evaluative situations. The present study examined similarities and distinctions between worry and anticipatory processing on potentially important maladaptive characteristics.

Methods

Participants (N = 279) engaged in idiographic periods of uninstructed mentation, worry, and anticipatory processing and provided thought samples during each minute of each induction. Thought samples were assessed for concreteness, degree of verbal-linguistic activity, and degree of imagery-based activity.

Results

Both worry and anticipatory processing were characterized by reduced concreteness, increased abstraction of thought over time, and a predominance of verbal-linguistic activity. However, worry was more abstract, more verbal-linguistic, and less imagery-based relative to anticipatory processing. Finally, worry demonstrated reductions in verbal-linguistic activity over time, whereas anticipatory processing demonstrated reductions in imagery-based activity over time.

Limitations

Worry was limited to non-social topics to distinguish worry from anticipatory processing, and may not represent worry that is social in nature. Generalizability may also be limited by use of an undergraduate sample.

Conclusions

Results from the present study provide support for Stöber's theory regarding the reduced concreteness of worry, and suggest that although worry and anticipatory processing share some features, they also contain characteristics unique to each process.

Section snippets

Participants

Participants were 279 undergraduate students from two large public universities who received course credit in exchange for their participation. Twenty-one participants were excluded for not completing the experiment (n = 7) or not providing enough thought samples (n = 14; final N = 258). Participants who were excluded did not differ from included participants on any symptom measures or on age (all ps > 0.100); however, participants at one site were more ethnically diverse relative to those at

Data analysis

Data for concreteness of thought samples, percentage of verbal-linguistic activity, and percentage of imagery-based activity were analyzed in separate 3 (Induction: uninstructed, worry, anticipatory processing) X 4 (Period: 1st, 2nd, 3rd, 4th) repeated measures analyses of variance (ANOVA). Main effects for Induction were followed up using simple within-subjects contrasts. Main effects for Period were followed up using polynomial within-subjects contrasts. Induction × Period interactions were

Baseline symptoms

Table 1 presents means and standard deviations of relevant symptom measures administered to participants at baseline, as well as normative data for community and clinical samples. We also sought to characterize the sample on theoretically relevant constructs, such as symptoms of depression as well as engagement in depressive rumination. The current sample evidenced scores that were typical of, although somewhat more elevated than, normative community samples on most measures. Between 18 and 27%

Discussion

Several authors (e.g., Ehring and Watkins, 2008, Harvey et al., 2004, McEvoy et al., 2010, McEvoy et al., 2013) have suggested that the various forms of RNT (e.g., worry, depressive rumination, anticipatory processing) constitute a common repetitive negative thinking factor, and that these types of RNT have more in common with each other than they have distinct features. However, no empirical study has investigated this proposition as it relates to comparisons between worry and anticipatory

Author note

This manuscript contains no conflicts of interest.

Acknowledgments and Declaration of Interest

The authors would like to thank the members of the coding team (Olivia Bjorkquist, Miranda Campbell, Brady Nelson, and Randi Schuster), as well as the research assistants who helped to collect the data (Mike Dunn, Wes Mantle, and Becky Robertson).

The authors have no conflicts of interest, financial or otherwise, that influenced this research.

References (81)

A.T. Beck et al.
Psychometric properties of the beck depression inventory: Twenty-five years of evaluation
Clinical Psychology Review
(1988)
E. Behar et al.
Screening for generalized anxiety disorder using the penn state worry questionnaire: A receiver operating characteristic analysis
Journal of Behavior Therapy and Experimental Psychiatry
(2003)
E. Behar et al.
Concreteness of positive, negative, and neutral repetitive thinking about the future
Behavior Therapy
(2012)
E. Behar et al.
Thought and imaginal activity during worry and trauma recall
Behavior Therapy
(2005)
T.D. Borkovec et al.
The effect of worry on cardiovascular response to phobic imagery
Behaviour Research and Therapy
(1990)
T.D. Borkovec et al.
The nature of worry in generalized anxiety disorder: A predominance of thought activity
Behaviour Research and Therapy
(1990)
T.D. Borkovec et al.
The role of worrisome thinking in the suppression of cardiovascular response to phobic imagery
Behaviour Research and Therapy
(1993)
T.D. Borkovec et al.
Preliminary exploration of worry: Some characteristics and processes
Behaviour Research and Therapy
(1983)
M.W. Eysenck et al.
Trait anxiety, defensiveness, and the structure of worry
Personality and Individual Differences
(1992)
A. Hackmann et al.
Recurrent images and early memories in social phobia
Behaviour Research and Therapy
(2000)

R.G. Heimberg et al.

Assessment of anxiety in social interaction and being observed by others: The social interaction anxiety scale and the social phobia scale

Behavior Therapy

(1992)

H. Hinrichsen et al.

Anticipatory processing in social anxiety: Two pilot studies

Journal of Behavior Therapy and Experimental Psychiatry

(2003)

C.R. Hirsch et al.

Self-images play a causal role in social phobia

Behaviour Research and Therapy

(2003)

E. Leigh et al.

Worry in imagery and verbal form: Effect on residual working memory capacity

Behaviour Research and Therapy

(2011)

A. Mathews

Why worry? the cognitive function of anxiety

Behaviour Research and Therapy

(1990)

R.P. Mattick et al.

Development and validation of measures of social phobia scrutiny fear and social interaction anxiety

Behaviour Research and Therapy

(1998)

P.M. McEvoy et al.

Are worry, rumination, and post-event processing one and the same? Development of the repetitive thinking questionnaire

Journal of Anxiety Disorders

(2010)

P.M. McEvoy et al.

The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct

Journal of Affective Disorders

(2013)

K.A. McLaughlin et al.

The effects of worry and rumination on affect states and cognitive activity

Behavior Therapy

(2007)

K.A. McLaughlin et al.

Rumination as a transdiagnostic factor in depression and anxiety

Behavior Research and Therapy

(2011)

D.S. Mennin et al.

Comorbid generalized anxiety disorder in primary social phobia: Symptom severity, functional impairment, and treatment response

Journal of Anxiety Disorders

(2000)

T.J. Meyer et al.

Development and validation of the penn state worry questionnaire

Behaviour Research and Therapy

(1990)

A.C. Mills et al.

The influence of anticipatory processing on attentional biases in social anxiety

Behavior Therapy

(2014)

A.C. Mills et al.

Relationship between trait repetitive negative thinking styles and symptoms of psychopathology

Personality and Individual Differences

(2014)

D.A. Moscovitch et al.

Retrieval properties of negative vs. positive mental images and autobiographical memories in social anxiety: Outcomes with a new measure

Behaviour Research and Therapy

(2011)

R.M. Rapee et al.

A cognitive-behavioral model of anxiety in social phobia

Behaviour Research and Therapy

(1997)

T.L. Rodebaugh et al.

The treatment of social anxiety disorder

Clinical Psychology Review

(2004)

J. Stöber

Worry, problem elaboration and suppression of imagery: The role of concreteness

Behaviour Research and Therapy

(1998)

C. Stokes et al.

Engaging in imagery versus verbal processing of worry: Impact on negative intrusions in high worriers

Behaviour Research and Therapy

(2010)

S.P. Vassilopoulos

Coping strategies and anticipatory processing in high and low socially anxious individuals

Journal of Anxiety Disorders

(2008)

N. Vrielynck et al.

Regulating emotion during imaginal exposure to social anxiety: Impact of the specificity of information processing

Journal of Behavior Therapy and Experimental Psychiatry

(2009)

E.R. Watkins et al.

Concreteness training reduces dysphoria: A pilot proof-of-principle study

Behaviour Research and Therapy

(2009)

M.O. Williams et al.

Verbal worry facilitates attention to threat in high-worriers

Journal of Behavior Therapy and Experimental Psychiatry

(2014)

Q.J.J. Wong et al.

Impact of anticipatory processing versus distraction on multiple indices of anxiety in socially anxious individuals

Behaviour Research and Therapy

(2011)

A.T. Beck et al.

Beck depression inventory-II. San Antonio

(1996)

T.D. Borkovec et al.

Avoidance theory of worry and generalized anxiety disorder

M. Brown et al.

Does anticipation help or hinder performance in a subsequent speech?

Behavioural and Cognitive Psychotherapy

(2007)

C.A. Chiupka et al.

In vivo activation of anticipatory vs. post-event autobiographical images and memories in social anxiety

Journal of Social and Clinical Psychology

(2012)

D.M. Clark et al.

A cognitive model of social anxiety

E.W. Cook et al.

Emotional imagery and the differential diagnosis of anxiety

Journal of Consulting and Clinical Psychology

(1988)

Cited by (14)

Social problem-solving attitudes and performance as a function of differences in trait and state worry
2023, Journal of Behavior Therapy and Experimental Psychiatry
This study investigated problem-solving attitudes and state-dependent, performance-based problem-solving abilities of individuals with high trait worry as compared to those low in trait worry. Secondary objectives involved investigating the relationship between problem-solving effectiveness and processes hypothesized to influence worry and problem-solving (i.e., working memory, attentional control, emotional dysregulation, and concreteness of thought).
A 2 (group: high worry, n = 68, vs. low worry, n = 66) X 2 (induction type: worry vs. neutral mentation) factorial design was employed to investigate the differential effects of state worry, and neutral mentation for comparison, on performance-based problem-solving effectiveness. Independent samples t-tests tested for group differences in self-reported problem-solving attitudes. Multiple regression analyses were used to investigate if aforementioned processes predict problem-solving effectiveness.
Previous findings that individuals with high trait worry endorse greater tendencies to self-report unconstructive problem-solving attitudes were replicated. Contrary to predictions, there were no significant within or between group differences on problem-solving performance. Concreteness of problem solutions was the only consistent predictor of problem-solving effectiveness.
Study did not directly assess problem-solving for personal problems.
Disparities in self-appraisal may account for lack of worry-related performance differences. Findings suggest that when employing problem-solving interventions with a high worry population, emphasis should be placed on changing maladaptive problem attitudes. Nonclinical and clinical populations alike may benefit from incorporating training in concreteness in problem-solving therapy.
A randomized experimental analysis of the attention training technique: Effects on worry and relevant processes in individuals with probable generalized anxiety disorder
2021, Behaviour Research and Therapy
The Attention Training Technique (ATT, Wells, 1990) is an intervention guiding individuals to focus, shift, and divide their attention in response to sounds presented in an audiorecording. The ATT has long been recommended for generalized anxiety disorder (GAD); however, there is insufficient research on its effects on excessive worry and related processes.
This experiment examined whether the ATT is more efficacious than a control intervention at reducing worry and modifying worry-related processes (e.g., attention control, negative metacognitive beliefs, attention bias, mindfulness).
78 adults with probable GAD.
Participants completed measures of worry and worry-related processes at the lab. They then monitored worry and attention daily for a week. Following this baseline, participants recompleted the lab measures and were randomly assigned to ATT or control. Participants listened to their assigned recording once/day for a week while again monitoring worry and attention daily. Participants then recompleted the lab measures.
The ATT did not perform better than the control condition on any measure. A variety of improvements were seen over the intervention period in both conditions.
ATT may not have meaningful effects on excessive worry and worry-related processes. Explanations for null findings are offered.
NCT03216382.
Concreteness of thoughts and images during suppression and expression of worry
2020, Behaviour Research and Therapy
Citation Excerpt :
We found that overall, concreteness decreased over time during verbal-linguistic thinking, whereas it remained stable during imagery-based thinking. These findings are consistent with theoretical assertions (Stöber, 1998) and empirical demonstrations (e.g., Behar et al., 2012; McGowan et al., 2017) that verbal-linguistic mentation is less concrete than imagery-based mentation. Furthermore, it adds to a growing literature indicating that as verbal-linguistic thinking becomes more prolonged, it becomes increasingly abstract (Behar et al., 2012; McGowan et al., 2017).
The avoidance theory of worry (Borkovec, Alcaine, & Behar, 2004) posits that the verbal-linguistic (versus imagery-based) nature of worry elicits abstract (versus concrete) processing, which inhibits affective responding and generates a host of negative consequences. Although suppression of worrisome thinking is maladaptive (Purdon, 1999), expression of worry using vivid imagery may increase concreteness of worrisome thinking and facilitate more adaptive emotional responding. The present study examined whether the valence, content, and expression of mentation impacts concreteness of thought. Participants (N = 62) were randomly assigned to verbalize their thoughts while engaging in either verbal-linguistic- or imagery-based mentation about both worrisome and neutral topics. Participants were also randomly assigned to engage in a 5-min period of suppressing or expressing the target stimuli before engaging in 5-min of freely expressing the targets. Verbalizations of mental content were coded for level of abstractness/concreteness. For neutral stimuli, imagery-based mentation led to greater concreteness than did verbal-linguistic mentation; however, for worrisome stimuli, imagery-based mentation did not enhance concreteness. In addition, for neutral (but not worrisome) stimuli, an initial period of suppression was associated with increased concreteness during subsequent expression. Imagery-based mentation about worrisome stimuli may not enhance concreteness; moreover, unlike suppression of neutral stimuli, suppression of worrisome stimuli may maintain, rather than ameliorate, abstractness of thought.
The effects of verbal and imaginal worry on panic symptoms during an interoceptive exposure task
2020, Behaviour Research and Therapy
Previous research has documented the inhibitory effects of worry on cardiovascular reactivity to subsequently presented fear-relevant stimuli. Although theoretical assertions point to the verbal-linguistic (as opposed to imagery-based) nature of worry as the cause of these inhibitory effects, extant research investigating the effects of worrisome thinking on subsequent anxiety-eliciting tasks has not isolated the verbal-linguistic nature of worry as the active ingredient in its suppressive effects on arousal. Furthermore, prior research has not examined the potential effects of worry on maintenance of panic symptoms. In this study, participants high in anxiety sensitivity were asked to engage in verbal worry, imaginal worry, or relaxation prior to each of three repeated presentations of an interoceptive exposure task. Relaxation was associated with lower initial subjective fear that remained low across repeated exposures, and related stable sympathetic arousal (and decreased heart rate) over time. Imagery-based worry was associated with moderate initial subjective fear that was sustained across repeated exposures, and sympathetic arousal (and heart rate) that was likewise stable over time. However, verbal worry was associated with high initial subjective fear that was sustained over time, but sympathetic arousal (and heart rate) that decreased across repeated exposures. Thus, verbal worry was uniquely associated with a lack of synchronous response systems and maintenance of anxious meaning over time. Theoretical and clinical implications are discussed.
Is repetitive negative thinking a transdiagnostic process? A comparison of key processes of RNT in depression, generalized anxiety disorder, obsessive-compulsive disorder, and community controls
2019, Journal of Behavior Therapy and Experimental Psychiatry
Citation Excerpt :
Overall, the ratings of abstractness and verbal qualitity were not very high. In this respect our findings are at odds with the majority of previous studies showing that several forms of RNT including rumination and worry are characterized by high abstractness (Goldwin & Behar, 2012; Watkins & Moulds, 2007a) and high verbal quality (McGowan et al., 2017; Molina et al., 1998; Wahl, Schoenfeld, et al., 2011; Watkins et al., 2005). One possible explanation for these discrepancies is the difference in methodology.
The transdiagnostic view of repetitive negative thinking (RNT) claims that different forms of RNT are characterized by identical processes that are applied to disorder-specific content. The purpose of the study was to test whether the processes of RNT differ across major depression disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD).
Forty-two individuals diagnosed with MDD, 35 individuals with GAD, 41 individuals with OCD, and 35 community controls were asked to think of a typical RNT episode and to rate its processes (core processes; use of mental capacity, unproductivity, abstractness, verbal quality, duration). Ratings were compared across groups using planned contrasts and analysis of variance.
All individuals with a clinical diagnosis rated the key processes of RNT and avoidance function of RNT as higher than healthy controls. There were no differences between individuals diagnosed with MDD, GAD or OCD on key processes and avoidance function of RNT.
Results are based on retrospective self-reports, which might restrict validity of the measurements.
Data support the transdiagnostic hypothesis of RNT. Transdiagnostic prevention and intervention techniques seem highly recommendable given these findings.
Enhancing the Efficacy of Cognitive Bias Modification for Social Anxiety
2018, Behavior Therapy
Cognitive bias modification for interpretation (CBM-I) is a promising treatment modality for social anxiety disorder, but effect sizes are relatively small across investigations (Hallion & Ruscio, 2011). Additionally, the extent to which CBM-I impacts other cognitive, emotional, and behavioral outcomes is unclear. This study investigated whether two empirically supported treatment components for anxiety disorders, imaginal exposure (IE) and relaxation, augment the effects of CBM-I and increase the extent to which the effects of CBM-I generalize to behavioral and affective outcomes. We randomly assigned 111 undergraduate students with social anxiety to undergo IE, relaxation, or neutral thinking prior to CBM-I, then measured their interpretation biases, as well as their speaking time, anxiety, and subjective evaluations of performance during a speech task. Results indicated that individuals who received IE prior to CBM-I evidenced more adaptive interpretation biases and less behavioral avoidance during the speech task than did individuals who engaged in relaxation or neutral thinking. However, they did not report differential anxiety, habituation, or evaluations of their performance on the speech task. These findings suggest that the combination of CBM-I with adjunct components that target behavioral, rather than cognitive, mechanisms can facilitate transfer of the effects of CBM-I to reducing behavioral avoidance.

View all citing articles on Scopus

View full text

Published by Elsevier Ltd.